'A deeply humanitarian spirit': MSF Canada director Joe Belliveau on how your support helped us respond to some of 2018's most challenging crises

In 2018, the support and generosity of Canadians helped Doctors Without Borders/Médecins Sans Frontières (MSF) continue to provide emergency humanitarian medical care to people in crisis, in more than 70 countries around the world.

In his year-end message of thanks to our supporters, MSF Canada Executive Director Joe Belliveau reflects on some of the many challenges we faced together over the past year, and how our shared humanitarian spirit makes it possible for us to bring care — and hope — to people with nowhere else to turn.

By Joe Belliveau

Over the past 12 months, Doctors Without Borders/Médecins Sans Frontières (MSF) medical teams have been on the front lines of some of the world’s most challenging emergencies, providing urgent assistance to people suffering from disease, displacement, conflict and neglect.

But if I could choose one personal moment from 2018 that captured the essence of what makes MSF a uniquely effective medical humanitarian organization, it was the time I spent last July with members of our emergency response team in Cox’s Bazar, Bangladesh.

Visiting the congested camps where close to one million Rohingya refugees have been trapped since fleeing targeted ethnic violence in Myanmar in late 2017, I saw first-hand the lifesaving difference our MSF doctors, nurses and other staff members are making.

Our clinics in Bangladesh are treating patients who remain exposed to infectious diseases, malnutrition, injuries and birthing complications, and who still suffer the mental trauma of their recent violent experiences. Our water and sanitation teams are helping prevent the spread of deadly diseases through the camps, and we are providing immunizations for members of this previously unvaccinated population — hundreds of thousands of whom poured across Bangladesh’s border with Myanmar into an incredibly confined series of displacement camps over the course of just a few days last year.

Pablo Tosco/Angular

Rohingya refugees wait for a distribution of food in Jatmoli makeshift settlement in Cox's Bazar, Bangladesh. MSF has been at the forefront of the emergency response in Cox's Bazar, providing urgent medical care to the nearly one million people fleeing ethnic violence in Myanmar.

Humanitarian spirit in action

I saw all of these essential activities in action when I was in Cox’s Bazar. But I also saw another, more fundamental element of MSF at work: That deeply humanitarian spirit that drives everyone in our organization — from medics in the field to staff around the world, to supporters like you across Canada — to do whatever is necessary to alleviate the suffering of a fellow human being.

That spirit is the heart of our medical humanitarian action. It is what drives our commitment to be wherever the needs are greatest and to bring lifesaving medical care to people who otherwise have no access to it — whoever they are and wherever they may be. It is a visceral form of basic human empathy, one that insists on seeing people who need our help not only as victims, but as fully individual human beings who deserve dignity as much as they require care.

In Bangladesh, I felt that spirit in MSF’s teams. I recognized it in the Toronto nurse I met, who worked tirelessly at a field clinic that received twice the number of daily patients as her large city hospital back home. I heard it from Bangladeshi MSF mental-health counsellors, who described to me the challenge of caring for people who had experienced brutal levels of trauma and loss while fleeing for their lives. And I saw it at the end of a long day in the camps, when my hosts and field colleagues finally had a moment to sit down and decompress — only to jump up and race back to the MSF hospital at the news that a young patient was struggling to breathe.

I met that patient the following day, still intensively attended to but recovering. She had access to the medical care she needs to survive, thanks to people like my colleagues, who do not hesitate to forego their after-hours rest time to respond to a single distressed child — and to people like you, who provide the essential support needed to make that possible. It is this spirit that drives our humanitarian action.

MSF

Hussein, a 30-year-old cafeteria worker, was part of a mass casualty influx of at least 72 injured and six dead at two hospitals supported by MSF, after a series of airstrikes last May in Sana'a, Yemen. The war in Yemen entered its fourth year in 2018.

2018: A year of humanitarian crises and global health emergencies

The Rohingya refugee crisis in Bangladesh was far from the only place where MSF’s medical response was urgently needed in 2018. Our teams were on the ground in more than 70 countries last year, often responding to complex humanitarian emergencies that threatened peoples’ health, hope and dignity. There are rarely quick solutions for these crises, but in the midst of disaster simple acts of medical care — while listening to people, and standing by them — can provide the strength they need to survive.

This was true in many of the places MSF worked last year. In Libya, our medical teams continued to visit some of the appalling detention centres where migrants seeking passage to Europe have been held in brutal, sub-human conditions. Hostages of the criminal gangs who run Libya’s people-smuggling networks, these men, women and children are being held for extortion and in many cases tortured, raped and deprived of food and water. MSF has negotiated access to some of these horrific places, in order to provide primary health care. It is a decision that has raised difficult questions — what can we achieve when there is so little hope of escape for most of the people we treat? — but these are also places of suffering that we simply cannot ignore.

In Yemen, a devastating civil conflict continued past its third year in 2018. The needs and suffering this war has created are deep and widespread. More than three million people have been displaced, and close to half the country — an estimated 20 million people — are in urgent need of humanitarian assistance. The health system has almost entirely collapsed, and relentless airstrikes have turned populated centres into fractured landscapes of destruction. But MSF remains on the ground, running medical facilities wherever possible. We are filling critical gaps: providing surgeries, attending births, treating the wounded and working to prevent the spread of resurgent diseases such as cholera and diphtheria.

At times we are confronted by diseases that rarely affect people in wealthier nations, and for which global expertise and treatments are limited. Diphtheria had been nearly eradicated last century, so outbreaks this past year in Yemen and in Bangladesh tested our teams who quickly became world-leading experts in managing and limiting these outbreaks.

The Democratic Republic of Congo (DRC) was also hit by large public-health emergencies this year, including two outbreaks of Ebola. MSF was — and still is — at the forefront of Ebola response efforts in the country, drawing on our lead-agency experience from the West African outbreak three years ago. This time, however, the devastating disease is spreading through an area at the centre of a violent conflict, which not only puts our staff at greater risk but heightens the challenge of contact-tracing to predict and contain the spread of the virus.

Farther away from the headlines, MSF also remained the world’s largest non-governmental treatment provider for tuberculosis (TB), a disease that kills more than 1.5 million people every year. The fact that so many people around the world have a disease that has mostly disappeared in richer countries (though it remains an increasingly urgent problem in Canada’s north) is shocking. This exposes a fundamental inequity in medical research. Under-investment in TB research means that no new affordable treatments have been developed in decades, leaving some of the world’s most vulnerable patients dependent on antiquated, painful and ineffective medicines. That’s why in 2018 MSF called on international governments, including Canada’s, to Step Up and take concrete measures to improve access to effective TB treatments.

Carl Theunis/MSF

MSF medical workers at the Ebola Treatment Centre in Mangina, Democratic Republic of Congo (DRC), where for the first time a research laboratory has been integrated into the facilities. MSF was once again on the front lines of a global Ebola response in 2018, following two separate outbreaks in DRC.

These are only a few examples of MSF’s global humanitarian medical efforts in 2018. When I pore through our operational updates from around the world, I am often struck by the sheer magnitude of crisis-induced humanitarian needs. How are our teams able to rise to this daunting and relentless challenge?

For me, the answer lies in that same humanitarian spirit. MSF has grown immensely since it first began almost five decades ago (and even since I first joined in 2000). But we retain the very same focus of purpose that has driven us from the beginning: We accept no borders, limits or deterrents to alleviating human suffering. We may not always succeed, but that spirit drives our ceaseless efforts. We deliver medical care wherever, whenever and for whomever the needs are greatest, regardless of identity, circumstances or difficulty. And we insist on telling the world what we see and hear in the process, so that no one is left to suffer in silence.

These fundamental values underlie a spirit that has not changed since I first became a part of MSF nearly 19 years ago. In 2000, I arrived in a refugee camp in Zambia, across the border from Angola, where a brutal civil war had killed or displaced millions. The people in the camp were villagers who had fled for their lives when armed groups launched violent raids. People had literally dropped everything in mid-activity and ran. What struck me most when I first arrived and walked through the camp was how eerily quiet it was: Barely a sound came from around the small cooking fires, despite the large numbers of people confined to such a small space.

I was there as a first-time logistician, responsible for building structures, recruiting local staff and supplying our medics. I joined MSF because of its unparalleled reputation for effective action, but I was a skeptic, uncertain of the impact we would have. The Angolans I met in Zambia were suffering as a result of forces we could not control, so would our efforts be anything more than a band-aid on a much deeper wound?

Months later, the environment in the camp had changed. We had built a clinic, a therapeutic feeding centre and a pharmacy, simple bamboo structures that nonetheless allowed our doctors and nurses to provide vital medical care. We had carried out a vaccination campaign to prevent the spread of disease. Just as important, we spent a lot of time listening. Because our patients told us there was no way they could return across the border to face more violence, we started a dialogue with the Zambian authorities with the goal of a longer-term stay for the refugees.

By then, the silence I heard when first walking through the camp was gone. Instead it was filled with the sounds of talking and working, and of playful children. My first overseas posting with MSF came to an end when I watched the last boats carrying the Angolan refugees toward the new land the Zambian government had permanently allocated for them, far away from the killing and violence they had fled.

I was hooked. If this was the impact MSF could have, then I wanted to stay a part of it.

Eighteen years later, that feeling remains. After many years on the front lines of MSF medical interventions and later managing operations from headquarters, 2018 was my first year as the Executive Director of MSF Canada. As my journey with this organization takes on different forms, I am heartened that the humanitarian spirit that drives it — in Zambia back in 2000 and in more than 70 countries today — continues.

Pascal Freneaux

Angolan refugees in Zambia, in the year 2000. MSF Canada Executive Director Joe Belliveau's first overseas posting with MSF was that same year, in a refugee camp in Zambia for people displaced by violence in Angola. Within a short time, he and his colleagues had built a clinic, a feeding centre and a pharmacy, and MSF had helped convince the Zambian government to resettle the refugees. "I was hooked," he says of seeing MSF's humanitarian impact for the first time.

A global network of people with a will to alleviate human suffering

Spirit alone, of course, is not sufficient to consistently meet the needs of so many people in the face of so many catastrophes. What makes MSF unique is the combination of that spirit with the means to put it into action. It is the efficiency of MSF’s supply chain, the medical kits that allow the set-up of a cholera treatment centre in a matter of hours; the proactive recruitment and staff-care that allows us to assemble teams immediately; and the expertise that allows us to deliver the highest quality medical care. And that is why it is so important that people like you, who are driven by the same spirit, are also part of the humanitarian actions we undertake.

It would be impossible for any of us, whether we are tracing the path of Ebola in Congo, advocating for better tuberculosis research in Canada, or sharing the stories of Rohingya refugees, to do what we do alone. The magic of MSF is that we are a huge network of people sharing a strong will to alleviate human suffering and restore human dignity, with the means to make it happen.

That network includes you, and all the supporters who make MSF’s work possible. Almost all of our funding comes from individual donors like you, rather than from governments or other large institutions. The trust you place in us to go wherever the needs are greatest, regardless of political or financial considerations, gives us the ability to act immediately and to respond fully wherever crises occur.

Together, we combine our shared humanitarian spirit with the means to make a difference.

When I look back at everything your support helped us do in 2018, I often think of that little girl in Cox’s Bazar, whose distressed breathing sent my colleagues racing back to the clinic after their working day was done. She was just one patient in a small field hospital, one of several MSF emergency facilities for the nearly one million traumatized Rohingya refugees, and one of hundreds more around the world.

Is it possible to save every life that needs saving? That is not the question a humanitarian asks. The question instead is: What is needed to save even just one life — and what role can I play to help save it?

Thank you for all that you have done to help us save lives around the world in 2018.

Best wishes to you and your loved ones this holiday season, and in the new year still ahead.